Lars Thuneberg

Guide to the identification of interstitial cells of Cajal.

The interstitial cell of Cajal, abbreviated ICC, is a specific cell type with a characteristic distribution in the smooth muscle wall throughout the alimentary tract in humans and laboratory mammals. The number of publications relating to ICC is rapidly increasing and demonstrate a rich variation in the structure and organization of these cells. This variation is species‐, region‐, and location‐dependent. We have chosen to define a “reference ICC,” basically the ICC in the murine small intestine, as a platform for discussion of variability. The growing field of ICC markers for light and electron microscopy is reviewed. Although there is a rapidly increasing number of approaches applicable to bright field and fluorescence microscopy, the location of markers by electron microscopy still suffers from inadequate preservation of ultrastructural detail. Finally, we summarize evidence related to ICC ultrastructure under conditions differing from those of the normal, adult individual (during differentiation, in pathological conditions, transplants, mutants, and in cell culture). Microsc. Res. Tech. 47:248–266, 1999.

Ultrastructure of interstitial cells of Cajal associated with deep muscular plexus of human small intestine

Evidence showing that interstitial cells of Cajal have important regulatory functions in the gut musculature is accumulating. In the current study, the ultrastructure of the deep muscular plexus and associated interstial cells of Cajal in human small intestine were studied to provide a reference for identification and further physiological or pathological studies. The deep muscular plexus was sandwiched between a thin inner layer of smooth muscle (one to five cells thick) and the bulk of the circular muscle. Interstitial cells of Cajal in this region very much resembled smooth muscle cells (with a continuous basal lamina, caveolae, intermediate filaments, dense bodies, dense bands, and a well-developed subsurface smooth endoplasmic reticulum), but the arrangement of organelles was clearly different, and cisternae of granular endoplasmic reticulum were abundant. Interstitial cells of Cajal were distinguished from fibroblasts or macrophages in the region. They ramified in the inner zone of the outer division of circular muscle, penetrated the inner-most circular layer, and were also found at the submucosal border. They were in close, synapselike contact with nerve terminals of the deep muscular plexus, and only few gap junctions with other interstitial cells of Cajal or with the musculature were observed. Compared with interstitial cells of Cajal from other mammals, those associated with the deep muscular plexus in the human small intestine more closely resemble smooth muscle cells, and their organization appears more diffuse; however, the ultrastructure and organization of interstitial cells of Cajal is compatible with modulatory actions on the circular muscle also in humans.

Toward a concept of stretch-coupling in smooth muscle. I. Anatomy of intestinal segmentation and sleeve contractions

Motility patterns and their structural basis were studied by video analysis, light and electron microscopy on the physiologically distended gut from normal and W/Wv suckling mice and normal adult mice. Empty or diltiazem‐relaxed intestine were used as references. In contrast to conventional primary aldehyde fixation, a brief primary fixation with osmic acid before aldehydes preserved the visible contraction patterns and revealed dynamic increases in the number of peg‐and‐socket junctions coupling muscle cells mutually and with interstitial cells of Cajal (ICC). In tissue engaged in segmentation, the major increase was in the circular muscle and involved the ICC‐DMP (integrated in the circular muscle layer at the site of the deep muscular plexus), whereas the increase during sleeve contractions was in the longitudinal muscle and involved the ICC‐AP (located at the site of Auerbachs plexus). The number and distribution of gap junctions were unaffected. Area analysis of cell profiles supported the involvement of circular muscle in segmentation, but longitudinal muscle alone in sleeve contractions. The gut of both normal and W/Wv sucklings (and adults) contracted during segmentation at frequencies close to reported slow‐wave frequencies. In W/Wv sucklings, ICC‐AP were absent whereas ICC‐DMP were present in adult configuration. Before Day 8 pp gap junctions were seen only between ICC‐DMP. In the sucklings ICC‐DMP may be responsible for rapid circumferential coordination and pacemaking of ring contractions. The geometry, organization, and dynamic regulation of peg‐and‐socket junctions strongly suggest a crucial role in coordination of smooth muscle and pacemakers, probably as stretch sensors, mediating a ‘stretch‐coupling’ in the system. Anat Rec 262:110–124, 2001.

One hundred years of interstitial cells of Cajal

This review is a portrayal of the evolution of ideas involving the interstitial cells of Cajal in changing disguises as dull fibroblasts, not very exciting Schwann cells, or perhaps quite important, though primitive neurons. However, today unmasked (we believe), they reveal themselves as myoid cells, a role that, judging by current interest, is far more exciting than former ones.

Interstitial cells of Cajal in human small intestine. Ultrastructural identification and organization between the main smooth muscle layers.

Previous morphological and electrophysiological studies have supported the hypothesis that interstitial cells of Cajal have important regulatory (pacemaker) functions in the gut. In the current study, interstitial cells of Cajal associated with Auerbachs plexus in human small intestine were studied. Freshly resected intestine was examined by light and electron microscopy. The interstitial cells of Cajal resembled modified smooth muscle cells. They had caveolae and dense bodies, an incomplete basal lamina, a very well-developed smooth endoplasmic reticulum, and abundant intermediate (10 nm) filaments. Myosin filaments were not seen. Fibroblast-like cells were distinguished by their lack of caveolae and dense bodies, the relative scarcity of smooth cisternae and intermediate filaments, and the abundant granular endoplasmic reticulum. Interstitial cells of Cajal were arranged in networks of bundles containing processes of two to seven cells with fibroblastlike cells interspersed in the bundles. The bundles were innervated by nerve elements of Auerbachs plexus and extended into both layers of smooth muscle, between muscle cells, and into septa. The bundles were closely associated with elastin fibers. The organization shown in this study strongly supports the concept of interstitial cells of Cajal as important regulatory cells also in the human small intestine. The characteristic cytology and organization of interstitial cells of Cajal may provide a basis for future morphological, electrophysiological, and pathological studies of these cells in human small intestine.

Ultrastructure of interstitial cells of Cajal in circular muscle of human small intestine

BACKGROUND Interstitial cells of Cajal (ICC) may be important regulatory cells in gut muscle layers. This study examined ICC within the circular muscle of human small intestine. METHODS Surgically resected, uninvolved intestine was studied by light microscopy and electron microscopy. RESULTS Muscle lamellae were separated by main septa in continuity with submucosa. Smooth muscle cells ran radially in the septa. Two types of ICC were distinguished. One ICC type had abundant intermediate filaments and smooth cisternae and a discontinuous basal lamina. This ICC type was present in the septa and in the outer third of the circular lamellae. The other ICC type had a complete basal lamina and conspicuous caveolae. This ICC type was observed only in the inner third of the circular lamellae. Both ICC types were close to nerves, but only the latter type formed gap junctions with one another and with muscle cells. Junctions between the two ICC types were not observed. CONCLUSIONS The arrangement suggests that ICC and radially oriented muscle cells participate in electrical and mechanical coordination of the circular muscle layer of human small intestine.

Development of pacemaker activity and interstitial cells of cajal in the neonatal mouse small intestine

Intestinal motor patterns are not well developed in premature infants. Similarly, in neonatal mice, irregular motor patterns were observed. Pacemaker cells, identified in the small intestine as interstitial cells of Cajal (ICCs) associated with Auerbachs plexus (ICC‐APs), contribute to the generation of peristaltic movements. The objective of the present study was to assess the hypothesis that abnormal gut motor activity in (preterm) newborns can be associated with underdeveloped ICCs. Specifically, the aim was to identify at which point the electrical pacemaker activity is fully developed and whether or not the development of pacemaker activity has a structural correlation with the developmental stage of ICCs. Pacemaker activity was identified as that component of the slow wave that is insensitive to L‐type calcium (Ca2+) channel blockers and displays a characteristic reduction in frequency in the presence of cyclopiazonic acid (CPA), a specific inhibitor of the endoplasmic reticulum Ca2+ pump. In newborn, unfed neonates, action potentials occurred that were irregular in frequency and amplitude and sensitive to verapamil. CPA (5 μM) abolished all action potentials. Quiescent spots were observed in approximately 50% of impalements. Six hours after birth, slow‐wave activity appeared at a regular frequency and amplitude, and a well‐defined plateau phase was observed. Verapamil did not affect the frequency, 5 μM CPA decreased it. The effect of CPA on the pacemaker frequency 2 days after birth was identical to that observed in adult mice. In 2‐hr‐old neonates, ICCs could be identified through selective uptake of methylene blue, but ultrastructural features were not fully developed. At 48 hr, a complete ICC network covering Auerbachs plexus was formed, confirmed by electron microscopy. In summary, the pacemaker component of the slow waves can be identified in neonates as early as 6 hr after birth. The pacemaker component was fully developed 2 days after birth. These electrophysiological observations correlated with the development of full network characteristics of ICC‐APs and the development of fully differentiated ICC‐APs from “blast‐like” cells. Dev. Dyn. 1998;213:271–282.

Immunohistochemical localization of a gap junction protein (connexin43) in the muscularis externa of murine, canine, and human intestine

Electron-microscopic studies have revealed a heterogeneous distribution of gap junctions in the muscularis externa of mammalian intestines. This heterogeneity is observed at four different levels: among species; between small and large intestines; between longitudinal and circular muscle layers; and between subdivisions of the circular muscle layer. We correlated results obtained with two immunomethods, using an antibody to the known gap-junctional protein (connexin43) with ultrastructural findings, and further evaluated the respective sensitivity of these two approaches. For comparative reasons we also included the vascular smooth muscle of coronary arteries into our study. Two versions of the immunotechnique (peroxidase-antiperoxidase and fluorescence methods) were applied to frozen sections of murine, canine, and human small and large intestines, as well as to pig coronary artery. In the small intestine of all three species a very strong reactivity marked the outer main division of the circular muscle layer, while the longitudinal muscle layer as well as the inner thin division of the circular muscle layer were negative. In murine and human colon both muscle layers were negative, while in canine colon the border layer between the circular muscle and the submucosa reacted strongly, and scattered activity was found in the portion of the circular muscle layer (one tenth of its thickness) closest to the submucosa. The remainder of the circular muscle layer and the entire longitudinal muscle layer were negative in the canine colon. In the coronary artery we could not confirm the positive, specific labeling reported by other investigators (l.c.). In conclusion, we found close correlations at all four above-mentioned levels in the distribution of gap junctions in the gut musculature, as determined by binding of anticonnexin43 in comparison to conventional ultrastructural studies. Since no significant immunostaining was found in (i) the outer border of the circular muscle layer of the canine colon and (ii) the border layer between the submucosa and the circular muscle layer of human colon, where rare gap junctions have been identified at the ultrastructural level, we conclude that the electron-microscopic analysis is the more sensitive of the two methods.

Macrophages in the Small Intestinal Muscularis Externa of Embryos, Newborn and Adult Germ-Free Mice

Previously, we demonstrated the presence of a constant and regularly distributed macrophage population of ramified cells in the intestinal muscle layers of smaller rodents. The function of these resident macrophages under normal conditions remains unknown. Histochemistry, immunohistochemistry and electron microscopy were applied to the muscularis externa of 15- and 17-day-old embryos, 2-day-old mice, adult germ-free and conventional mice. Since lipopolysaccharides (LPS) activates macrophages and inflammation affects gut motility, LPS-treated mice were also included in the study. Two macrophage antibodies, F4/80 and 2F8 were used to demonstrate the presence of macrophages in the muscle layers. The localization was confirmed by electron microscopy. In contrast to conventional adult mice, the muscle layers in embryos, newborn and germ-free adult mice were devoid of class II MHC antigen reactive cells. The acid phosphatase reaction and antibodies directed towards a lysosomal protein (Lamp-2) were used in order to verify other activation markers. None of these showed specific staining of the muscularis macrophages. Only LPS-treated adult mice showed iNOS-positive cells in whole mounts. We conclude that the characteristic organization and distribution of muscularis macrophages in adult mice are also present in embryos, newborn and germ-free mice and thus develop independently of foreign antigens. Further, these macrophages are truly resident and appear to have differential responses to exogene stimuli.

Intercellular communication in smooth muscle

The functioning of a group of cells as a tissue depends on intercellular communication; an example is the spread of action potentials through intestinal tissue resulting in synchronized contraction. Recent evidence for cell heterogeneity within smooth muscle tissues has renewed research into cell coupling.Electrical coupling is essential for propagation of action potentials in gastrointestinal smooth muscle.Metabolic coupling may be involved in generation of pacemaker activity. This review deals with the role of cell coupling in tissue function and some of the issues discussed are the relationship between electrical synchronization and gap junctions, metabolic coupling, and the role of interstitial cells of Cajal in coupling.